AN  ACCOUNT  OF  THE  BILLIOUS  FEVER 
IN  NEWBERN,  N.  C.  IN  THE  FALL  OF  1841 


NEW  YORK  MEDICAL  GAZETTE  1842 


HEALTH  SCIENCES  LIBRARY 
OF  THE 

UNIVERSITY  OF  NORTH  CAROLINA 
AT  CHAPEL  HILL 


From  the  Books  of 

WILLIAM  P.  Jacocks,  M.D. 

Class  of  1904 
Friend  of  the  Library 


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THE 


V.  /  y^CCU*  y 

i*op  U  n\t^J  1 c  /  k 3 


NEW  YORK  MEDICAL  CAZETTE. 

. OI^SIQKL  QE JHE ALTH  AFFAIRS  LIBRARY _ 

No.  11.  MARCH  23,  1842.  Vol.  2. 


ORIGINAL  DEPARTMENT. 


An  Account  of  the  Billions  Fever ,  as  it  prevailed  in  Newbern,  N.  C. 
in  the  Fall  of  1841.  By  Geo.  H.  Taylor,  M.  D. 


In  giving  an  account  of  the  fever  as  it  prevailed  in  New¬ 
bern  during  the  late  fall,  it  will  be  proper  to  premise  a  brief 
description  of  the  place,  its  location,  etc.  The  town  contains 
about  four  thousand  inhabitants,  is  situated  on  low  ground  at  the 
junction  of  two  rivers,  the  Neuse  and  Trent,  the  former  running 
along  the  Eastern  border  of  the  town,  and  the  latter  running  along 
the  Southern  border.  A  little  to  the  southwest  of  the  town  lies  a 
marsh  several  miles  in  length,  and  about  half  a  mile  in  breadth.  A 
short  distance  from  the  northwest  part  of  the  town  are  a  number  of 
large  ponds,  which  contain  a  considerable  quantity  of  water  all  the 
year  round,  having  no  outlet  to  the  river.  There  are  also  in  one  or 
two  parts  of  the  town,  a  number  of  low  places,  in  which  water  is 
permitted  to  remain  a  good  part  of  the  year,  the  quantity  being 
more  considerable  after  heavy  rains.  These  points  it  is  important 
to  bear  in  mind,  when  we  come  to  consider  the  cause  of  the  great 
prevalence  of  disease  with  which  the  inhabitants  are  afflicted,  to  a 
greater  or  less  extent,  almost  every  autumn,  and  which  prevailed 
during  the  fall  just  passed,  to  a  much  more  alarming  degree  than  for 
many  previous  years. 

During  the  summer  months  there  were  but  few  cases  of  fever ; 
early  in  September,  however,  the  town  having  been  previously  visi¬ 
ted  by  heavy  rains,  a  number  of  cases  occurred  simultaneously  in 
various  parts  of  the  town.  There  was  no  part  of  the  town  that  es¬ 
caped  entirely ;  but  those  parts  most  adjacent  to  the  marsh  and 
ponds  before  referred  to,  were  visited  in  a  peculiar  manner,  scarcely 
a  family  in  such  quarters  escaping,  and  in  many  cases  every  member 
of  such  families  being  down  with  the  disease.  There  was  a  marked 
difference,  however,  in  the  disease,  as  it  appeared  in  the  vicinity  of 

11 


162 


Bilious  Fever. 


the  marsh,  and  near  the  ponds,  those  cases  in  the  neighborhood 
of  the  former  yielding  promptly  to  remedies,  scarcely  a  case 
proving  fatal,  while  those  in  the  vicinity  of  the  latter  were  much 
more  obstinate,  successfully  resisting  all  remedies,  and  many  of  the  • 
cases  terminating  fatally. 

The  general  form  of  the  disease  was  that  of  the  bilious  intermit¬ 
tent  and  remittent  fever,  usually  commencing  with  languor,  uneasy 
and  painful  sensations,  followed  with  coldness  of  the  nose,  hands 
and  feet,  sometimes  with  shivering  and  cold  sensations  running  up 
and  down  the  spinal  column.  These  symptoms  would  continue 
from  a  half  hour  to  three  hours,  and  be  followed  by  heated  skin, 
thirst,  flushed  countenance,  and  the  usual  symptoms  of  fever,  which 
would  in  many  cases  continue  for  about  twenty-four  hours,  when 
another  chill  would  supervene.  In  the  generality  of  cases,  however, 
on  the  day  following  the  first  ague,  there  would  be  only  a  slight 
chilliness  of  the  extremities,  lasting  but  a  short  time,  followed  by 
fever  ;  and  the  day  succeeding  the  chill  the  patient  would  experi¬ 
ence  what  is  called  a  “  shaking  ague.”  And  in  this  form  the  dis¬ 
ease  would  continue  till  it  terminated  in  death  or  convalescence. — 
Some  patients  who  were  not  visited  with  the  “  shaking  agues,” 
would  experience  as  many  as  half  a  dozen  chills  in  the  course  of  a 
day. 

Occasionally  the  disease  assumed  the  purely  tertian  type,  the  ague 
returning  regularly  every  forty-eight  hours,  lasting  from  one  to  three 
hours,  followed  by  fever  that  would  continue  generally  from  five  to 
ten  hours,  sometimes  abating  after  a  copious  sweat,  and  some¬ 
times  continuing  during  the  whole  period  from  one  ague  to  another. 

In  some  cases,  in  the  commencement  of  an  attack, the  paroxysms 
would  assume  a  very  mild  form,  so  as  for  the  first  few  days  not  to 
confine  the  patient.  But  each  succeeding  paroxysm  would  become 
more  violent,  and  in  a  few  instances  the  patient  died  in  the  cold 
stage  of  the  third  or  fourth  paroxysms,  no  reaction  taking  place  ; 
although  the  patient  appeared  a  short  time  before  the  ague  to  be  in 
a  comfortahle  condition,  and  to  entertain  no  apprehension  of  death. 

I  was  requested  to  prescribe  for  a  patient,  an  adult  female  who  had 
been  for  several  days  suffering  with  the  chill  and  fever,  but  who,  at 
the  time  I  saw  her,  in  the  morning,  appeared  quite  well  and  was  at¬ 
tending  to  her  household  affairs.  I  prescribed,  as  requested,  and 
at  about  two  o’clock  in  the  afternoon,  was  called  in  great  haste  to 
see  her,  as  she  appeared  to  be  in  a  dying  condition.  I  found  her 
insensible,  breathing  heavily,  with  the  eyes  fixed  and  pupils  some¬ 
what  dilated,  the  surface  of  the  body  generally  being  of  a  natural 
temperature,  excepting  the  extremities  which  were  cool.  The  pulse 
was  frequent  and  feeble.  Her  ague  had  come  on  at  the  usual  time, 
and  feeling  more  indisposed  than  on  former  occasions,  she  had  retired 
to  bed,  and  in  about  twenty  minutes  from  the  commencement  of  the 
paroxysm  she  became  speechless,  and  had  since  remained  in  the 


Bilious  Fever. 


163 


condition  in  which  I  found  her.  Directing  a  large  sinapism  to  be 
applied  to  the  epigastrium,  and  others  to  the  ancles,  I  waited  for 
half  an  hour  in  the  expectation  that  they  would  rouse  her  ;  but  find¬ 
ing  she  continued  in  the  same  state,  notwithstanding  the  mustard 
had  sufficiently  excited  the  skin,  I  commenced  stimulating  her  with 
ammonia,  under  the  influence  of  which  she  was  soon  roused  so  as 
to  be  able  to  converse.  So  soon,  however,  as  the  effects  of  the 
ammonia  were  expended  she  would  relapse  into  her  former  state. — 
Finding  the  pulse  at  times  to  grow  very  feeble,  1  continued  the 
ammonia  at  intervals  of  a  half  hour,  during  the  afternoon  and  eve¬ 
ning,  at  which  time  I  directed  a  sinapism  to  the  back  of  the  neck, 
and  left  her.  She  continued  in  a  state  of  stupor  for  several  days, 
after  which  it  gradually  wore  off,  and  she  had  no  return  of  the 
chills.  Quite  a  number  of  cases  similar  to  the  above  occurred  about 
the  same  time. 

The  appearance  of  the  tongue  at  the  commencement  of  an  attack 
was  usually  natural,  but  it  became  covered  with  a  whitish  coat  as 
the  disease  progressed,  which  changed  gradually  to  a  yellowish  and 
brownish  hue,  and  sometimes,  when  the  disease  continued  for  a 
great  length  of  time,  the  tongue  became  covered  with  an  entirely 
black  coat,  being  also  very  dry,  and  cracked  with  a  longitudinal  and 
numerous  transverse  fissures.  In  almost  every  case  the  patient 
complained  of  pain  in  some  part  of  the  body,  often  in  the  head  and 
shoulders,  back  and  legs,  frequently  of  pain  and  a  sense  of  weight 
about  the  epigastrium,  and  right  hypochondrium,  and  in  many  cases 
of  permanent  pain  in  the  region  of  the  spleen.  The  fever  following 
the  cold  stage  was  frequently  very  high,  attended  with  hot  and  dry 
skin,  quick  and  full  pulse,  and  often  delirium.  There  was  generally 
a  manifest  abatement  or  aggravation  of  the  symptoms  about  the 
seventh  day — in  some  cases  the  patient  would  die  at  this  period- 
in  others,  there  would  be  a  remarkable  transition  from  a  state  indi¬ 
cating  approaching  death,  to  one  of  striking  amendment,  and  in 
others,  again,  the  patient  would  sink  into  a  stupor,  with  frequent 
and  feeble  pulse,  and  a  low  muttering  delirium,  in  which  state  he 
would  remain  several  days,  and  from  which  but  few  ever  recovered, 
death  then  terminating  the  scene.  In  the  cases  that  proved  fatal 
this  was  the  most  common  termination.  Quite  a  number  of  cases 
were  complicated  with  a  troublesome  cough.  The  prirnae  vise  were 
frequently  found  in  a  constipated  state.  In  a  few  cases  the  surface 
of  the  body  was  of  a  bright  yellow  hue.  In  a  large  proportion  of 
cases  there  was  great  irritability  of  the  stomach,  and  violent  vomit¬ 
ing  often  formed  a  very  unpleasant  and  obstinate  symptom,  the  fluid 
ejected  being  of  a  greenish  or  yellowish  cast. 

In  the  treatment  of  the  cold  stage  of  this  disease,  little  was  usually 
done  by  the  writer,  except  placing  the  patient  in  bed,  covering  him 
with  blankets,  placing  hot  bricks  or  bottles  of  hot  water  to  the  ex¬ 
tremities,  and  directing  some  warm  mild  tea  ;  although  when  the 


164 


Bilious  Fever. 


cold  stage  was  considerably  protracted,  he  was  in  the  habit  of  ex¬ 
hibiting  a  full  dose  of  the  tincture  of  opium,  and  if  necessary  repeat¬ 
ing  it,  with  much  benefit.  In  the  hot  stage,  however,  more  active 
remedies  were  required.  Where  it  was  not  contra-indicated  by 
gastric  irritability,  I  have  in  this  stage  exhibited  the  aqueous  solution 
of  tartarized  antimony,  in  small  doses,  frequently  repeated,  with 
marked  advantage,  and  in  a  number  of  instances  have,  with  this 
remedy  and  a  mercurial  cathartic,  entirely  cut  short  the  disease. — 
In  many  cases,  however,  the  antimony  could  not  be  employed,  and 
I  have  directed  in  its  stead  the  acetate  of  ammonia,  with  much  relief 
to  the  patient,  the  use  of  it  being  followed,  after  a  few  doses,  with  a 
copious  perspiration,  and  an  abatement  of  all  the  symptoms.  Where 
the  fever  continued  for  a  long  time,  as  it  frequently  did,  only  slightly 
subsiding  on  the  recurrence  of  a  chilliness  of  the  extremities,  I 
have  directed  powders  consisting  of  nitrate  of  potass,  gr.  viij.,  sub. 
mur.  hydrag.  gr.  ss.,  and  tartarized  antimony,  gr.  1  -8th.,  repeated 
every  few  hours,  also  with  much  benefit. 

So  soon  as  the  fever  sufficiently  subsides,  however,  a  remedy  not 
to  be  forgotten  is  the  sub.  mur.  hydrarg.,  in  a  full  dose  alone,  or  in 
combination  with  rhubarb,  the  latter  of  which  I  prefer  and  gener¬ 
ally  employ.  Indeed  my  first  aim  on  visiting  a  patient  was  to  clear 
the  primse  vise  with  rhubarb  and  calomel ;  for  the  catharsis  indu¬ 
ced  by  this  combination  is  not  attended  with  that  debility,  which  re¬ 
sults  when  the  calomel  is  used  in  a  dose  sufficiently  largo  to  affect 
the  first  passages  alone,  or  when  it  is  followed  by  castor  oil  or  the 
sulphate  of  magnesia. 

The  next  and  most  important  part  of  the  treatment  is  that  which 
is  designed  to  prevent  a  recurrence  of  the  paroxysm,  for  when  this 
is  accomplished,  the  regular  course  of  the  disease  is  interrupted  and 
a  speedy  recovery  may  be  expected.  Recollecting  the  fact,  that  the 
fever  generally  continued  from  one  ague  to  another,  it  is  manifest 
that  the  sulphate  of  quinine  could  not  be  employed  with  advantage 
in  such  cases,  to  fulfil  the  end  under  consideration.  Even  where  a 
total  subsidence  of  the  fever  had  taken  place,  I  have  been  frequently 
disappointed  when  depending  on  the  free  use  of  quinine  to  prevent 
the  recurrence  of  the  ague.  Keeping  in  mind  the  violence  of  the 
cold  stage,  the  great  danger  attending  it,  and  the  state  of  prostration 
in  which  it  uniformly  left  the  patient,  together  with  the  fact  that 
the  usual  means  had  failed  to  prevent  its  return,  it  became  necessary 
for  the  physician  to  adopt  some  other  means  to  accomplish  an  end 
so  desirable.  Taking  the  hint  from  Good,  after  previous  purgation, 
I  employed  for  this  purpose  a  full  dose  of  the  compound  powder  of 
ipecac,  about  two  hours  before  the  period  for  the  return  of  the  par¬ 
oxysm,  with  entire  success.  The  same  remedy  I  repeated  in  some 
twenty  or  thirty  cases  with  the  same  beneficial  result,  in  nearly  every 
case  in  which  the  paroxysms  observed  any  uniformity  in  the  time  of 
their  approach.  If  this  remedy  failed  on  the  first  trial,  as  it  did  in 
a  few  instances,  I  do  not  recollect  that  in  any  case  it  failed  after  the 


Bilious  Fever. 


165 


second  trial.  One  great  advantage  in  the  use  of  this  remedy  is,  that 
you  need  not  abstain  from  its  employment  on  account  of  the  pre¬ 
sence  of  fever.  In  about  two  hours  after  its  exhibition  a  general 
composure  would  pervade  the  system,  the  patient  would  be  inclined 
to  sleep,  and  a  gentle  perspiration  would  break  out  upon  the  surface 
of  the  body.  In  quite  a  number  of  cases,  the  Dover’s  powder  was 
the  only  remedy  used  after  purgation,  to  prevent  the  recurrence  of 
the  agues ;  and  I  am  not  aware  but  those  cases  recovered  as  well 
and  as  speedily  as  those  in  which  the  quinine  was  employed.  I 
would  not  however  discard  quinine,  considering  it  a  valuable  aux¬ 
iliary,  to  be  used  freely  during  the  intermission,  but  not  to  be  en¬ 
tirely  relied  upon  to  prevent  the  return  of  the  paroxysm,  which,  con¬ 
sidering  the  great  danger  attending  the  cold  stage,  is  a  paramount 
object  with  the  physician. 

In  many  cases  during. the  ague,  and  even  after  reaction  has  taken 
place,  the  patient  complained  of  a  constant,  painful  and  heavy  sen¬ 
sation  about  the  region  of  the  epigastrium,  attended  with  shortness 
of  breath.  These  symptoms  were  greatly  relieved  by  taking  over 
night  about  eight  grains  each  of  calomel  and  Dover’s  powder.  In 
directing  Dover’s  powder  in  this  disease,  I  think  it  good  practice 
generally  to  add  to  it  a  small  quantity  of  calomel.  In  eight  cases 
out  of  about  seventy-five  that  I  attended  during  the  fall,  there  was  a 
perceptible  enlargement  of  the  spleen. 

The  fever  continued  to  prevail  from  early  in  September  till  the 
latter  part  of  October,  after  which  but  few  new  cases  occurred.  I 
have  no  means  of  ascertaining  the  number  of  deaths  that  took  place 
during  the  fall  but  can  only  say  that  it  was  greater  than  had  occur¬ 
red,  from  the  same  disease,  during  any  season  within  the  recollection 
of  the  oldest  inhabitants. 

The  effluvium  arising  from  the  decomposition  of  vegetable  mat¬ 
ter,  is  undoubtedly  the  principal  remote  cause  of  the  disease,  as  the 
cases  were  invariably  more  numerous  and  fatal  in  the  neighborhood 
of  those  situations  where  the  materials  for  the  generation  of  this 
effluvium  were  most  abundant.  Considering  the  unusual  and  vio¬ 
lent  form  assumed  by  the  disease  during  the  late  Fall,  there  is  rea¬ 
son  to  fear,  that,  unless  the  cause  of  disease  be  greatly  diminished, 
our  town  may  be  visited  on  the  coming  or  some  subsequent  Autumn, 
by  that  annual  scourge  of  more  Southern  cities,  the  yellow  fever ,  as 
an  epidemic.  “  The  occurrences,”  says  a  medical  writer,  “  which 
preceded  the  appearance  of  the  epidemic  of  Barcelona,  in  1821,  cor¬ 
respond  with  the  old  and  recent  observations  on  a  similar  subject  in 
other  countries  ;  it  almost  invariably  happening  that  the  yellow  fever 
is  preceded  by  unusual  diseases  of  various  form  and  force  ;  more 
particularly  by  bilious  remittents,  which  are  not  unfrequently  so  ag¬ 
gravated  and  malignant,  that  physicians  themselves  do  not  venture 
to  define  the  lines  of  demarkation  between  them  and  the  avowed 
epidemic.” 

Newbern ,  N.  C.,  December ,  1841. 


1 66 


Notes  of  Clinical  Lectures. 


Reports  of  Clinical  Lectures ,  delivered  in  the  Anatomical  Theatre  of 

the  College  of  Physicians  and  Surgeons ,  Crosby  Street.  Willard 

Parker,  M.  D.,  Professor  of  Surgery. 

Case  1. — Gentlemen,  the  first  case  (child  of  four  years  of  age) 
is  one  of  disease  of  the  spine,  affecting  the  vertebra? — the  7th,  8th,  and 
9th  dorsal.  It  is  a  posterior  curvature.  Only  another  case  of  the 
many  we  have  already  witnessed  the  past  winter  at  this  Clinique. 
I  have  already  made  many  observations  on  this  class  of  affections, 
and  will  now  only  add  a  few  more.  Not  unfrequently,  previous  to 
any  suspicion  of  spinal  disease,  you  will  be  called  to  children  affec¬ 
ted  with  pain  in  the  abdomen.  The  mothers  don’t  know  any  par¬ 
ticular  cause  for  this — child  seems  pretty  well,  except  at  times,  it 
complains  of  pain  about  the  scrobiculus  cordis.  Well,  by  and  by, 
irregularity  of  bowels  comes  on,  and  then  spasms  of  the  lower  ex¬ 
tremities,  then  tripping  in  the  gait,  and  finally  inability  to  walk. — 
Whenever,  therefore,  you  are  called  to  children  with  these  pains 
about  the  scrobuculus  cordis,  recurring  every  now  and  then,  I 
would  advise  you  to  examine  the  spine  at  once  ;  and  this  more  es¬ 
pecially  if  there  have  been  present,  nausea  and  irregularity  of  the 
bowels.  The  symptoms  it  is  true  may  result  from  other  causes. — 
'This  you  will  attend  to  of  course.  Should  however,  nothing  seem 
to  be  offending  the  canal  by  its  presence — should  this  pain  in  the  ab¬ 
domen  recur  every  now  and  then,  without  your  being  able  to  detect 
any  abdominal  trouble,  just  pass  your  hand  over  the  spine,  and  per¬ 
haps  you’ll  find  your  little  patient  flinches  at  a  particular  spot.  If 
so,  you’ll  have  the  satisfaction  of  having  detected  the  disease  early 
and  thus  be  enabled  to  benefit  your  patient  incalculably  more  than 
if  the  disease,  mistaken,  is  allowed  to  progress  for  months  longer. — 
This  disease  usually  manifests  itself  between  the  ages  of  two  and 
six  years.  The  dorsal  vertebrae  are  far  more  frequently  affected 
than  any  other  part  of  the  column.  Of  more  than  twelve  cases,  I 
have  lately  seen,  all  but  one  had  the  seat  of  the  disease  in  the  dorsal 
vertebrae.  One  piece  of  advice  let  me  give  you,  in  these  cases,  never 
promise  too  much,  and  never  fix  the  time  when  you  are  to  effect  a 
cure.  They  are  the  most  tedious  cases  you  can  have,  and  require 
time — months  and  years.  Mow,  after  an  issue  has  been  set  up  for 
some  time,  you  may  put  on  an  apparatus  that  shall  bring  up  the 
body  to  the  erect  position,  keep  the  patient  from  becoming  more 
curved  in  his  figure,  and  hide  the  deformity. 

Case  2. — This  woman  is  affected  with  stammering — you  know 
that  an  operation  for  the  relief  of  this  defect  has  lately  been  very  much 
in  vogue — but,  gentlemen,  I  tell  you  it  has  had  its  run.  Like  other 
surgeons,  I  operated  upon  all  who  called  upon  me  for  the  relief  of 
this  unpleasant  defect,  and  was  gratified  to  find,  that  they  all  uttered 
so  much  more  distinctly, just  after  the  operation,  than  they  could  utter 


167 


Notes  of  Clinical  Lectures . 

before  the  operation  ;  but  in  10  to  14  days  I  found  them  coming 
back  again  stammering  as  bad  as  ever.  I  have,  therefore,  abandoned 
the  operation.  I  pronounce  it  a  failure  and  cannot  conscientiously 
recommend  it.  And  if  you  will  reflect,  for  a  moment,  you  will  see 
how  little  cause  there  is  for  believing  that  we  have  hit  upon  the  right 
operation  as  yet.  Dieflenbach,  of  Berlin,  first  cut  into  the  tongue 
itself.  The  hemorrhage  that  followed  was,  sometimes  frightful,  as 
you  might  suppose.  Well,  he  cured  of  course.  Some  of  the  Paris 
surgeons  thought  that  this  was  going  a  little  too  deep,  so  they  took 
to  dividing  the  genio-hyo-glossus  muscle ;  and  they  cured  too — finally 
a  Mr.  Yearsly,  of  England,  conceived  that  cutting  even  any  muscle 
was  cutting  too  deep,  so  he  went  to  snipping  off  little  pieces  from 
the  soft  parts  of  the  fauces, — as,  the  end  of  the  velum  pendulum 
palati,  the  folds  of  mucous  membrane  of  the  fauces  and  the  tonsils  ; 
and  he  cured  too — now,  gentlemen,  it  is  evident  there  is  some  de¬ 
ception  in  all  this.  These  cures  I  very  much  doubt.  I  divided  the 
genio-hyo-glossus  muscle,  the  muscle  divided  now  for  this  operation, 
but  I  do  not  know  that  it  ever  was  successful  in  a  single  instance. 

Case  3. — This  man,  an  Irishman,  received  a  kick  about  7  weeks 
since  on  the  left  shoulder  and  arm  from  a  horse,  while  shoeing  him; 
and  you  see  he  is  not  well  yet.  There  is  no  fracture,  no  disloca¬ 
tion  ;  simply  a  contusion — a  severe  contusion  is  often  worse  than  a 
fracture.  You  will  have  cases  of  this  kind,  and  they  will  trouble 
you  exceedingly — of  a  simple  fracture  you  can  give  some  idea  when 
it  will  be  sound  again  ;  but  when  a  contusion  will  get  well  you  can’t 
say.  He  is  an  alcoholic  subject ;  and  in  such  you  will  find  that,  du¬ 
ring  cold  weather,  bruises,  contusions,  do  not  get  along  at  all,  but 
as  soon  as  warm  weather  comes  on  they  recover  rapidly.  Let  this 
man  have  the  shower  bath,  some  stimulating  application  to  the  part 
and  use  of  the  arm  and  he  will  recover. 

Here,  gentlemen,  is  a  case  of  syphilis.  This  man  has  a  chancre 
behind  the  corona  glandis,  it  is  well  worth  your  while  to  observe  this 
case.  Surgeons  have  written  much  about  the  venereal  ;  but  there 
is  much  yet  to  be  learned.  I  believe  there  is  a  wide  difference  be¬ 
tween  syphilis  and  gonorrhoea — in  fact  they  are  two  distinct  disea¬ 
ses.  Now  as  to  chancre  there  are  the  Pustular,  Phagedenic,  and 
the  Hunterian.  The  Hunterian  is  rare — the  Pustular  the  most  com¬ 
mon — this  man’s  is  pustular.  You  see  an  enlargement  of  the  gland 
in  the  groin.  It  is  a  bubo.  Now  in  scrofula  several  glands  are  en¬ 
larged,  in  syphilis  only  one.  You  may  have  one  on  each  side,  and 
then  you  have  what  sailors  call  “  a  watch  on  both  sides.”  Observe, 
too,  in  gonorrhoea  you  have  a  bubo ;  but  its  tendency  is  not  to  sup¬ 
purate,  while  syphilitic  buboes  always  do  tend  to  suppuration,  and 
sometimes  rapidly.  Bubo  sometimes  comes  on  in  ten  to  twelve 
days  after  the  sore  on  the  penis,  but  sometimes  not  for  six  months. 
This  is  the  longest  period  I  ever  knew  before  it  made  its  appear- 


\68 


Notes  of  Clinical  Lectures. 


ance.  This  man  looks  quite  stout  and  hearty,  V.  S.  may,  therefore, 
not  improperly  be  practised  on  him.  A  dose  of  calomel  at  night, 
and  salts  with  antim.  tart,  in  the  morning — gruel  diet.  Local  treat¬ 
ment  should  be — keep  the  parts  clean,  and  pledgets  of  lint,  dipped  in 
lime  water,  or  black  wash  laid  on.  A  very  useful  work  was  pub¬ 
lished  in  England  some  time  ago,  and  reprinted  in  this  country  by 
Langston  Parker.  The  first  part  of  the  work  is  devoted  to  the  con¬ 
sideration  of  affections  of  the  digestive  Organs.  And  the  second  to 
gonorrhoea  and  syphilis.  The  views  of  Dr.  Parker  are  those  of  Ri- 
card  condensed.  Ricord  is  decidedly  the  best  living  authority  on 
this  subject,  and  hence  the  work  of  Parker  is  of  decided  value. 

By  Dr.  Bulkley.  Cutaneous  Diseases.  Case  5. — This,  gen¬ 
tlemen,  is  a  case  of  papular  disease.  Of  this  order,  Willan  makes 
three  genera — Strophulus,  Lichen  and  Prurigo.  While  Biett  whose 
classification  I  follow  makes  only  two,  Lichen  and  Prurigo — consid¬ 
ering  Strophulous  a  species  of  Lichen,  by  which  the  matter  is  sim¬ 
plified,  as  it  is  merely  a  form  of  papular  disease  running  in  infants. 
Now,  all  these  are  distinguished  by  the  shot-like  feel  when  you  pass 
your  hand  over  them — they  are  slight  elevations,  and  are  at  once 
recognized  by  the  sensation  conveyed.  You  will  find  it  frequently 
at  the  joints,  and  sometimes  on  the  groins  as  well  as  on  other  parts 
of  the  body,  occurring  often  in  patches  of  the  size  of  a  two  shilling 
piece  ;  and  soon  attaining  a  larger  size.  It  affects  all  ages — and  results 
from  alimentary  disturbances  and  frequently  from  exposure  to  heat ; 
hence  workmen  in  foundries,  cooks,  and  glass-blowers,  are  liable 
to  it.  Cleanliness  and  attention  to  diet,  and  regulating  the  digestive 
organs  are  curative  means. 

This  next  case,  in  this  little  boy,  is  one  of  Impetigo.  It  is  a  pus¬ 
tular  disease.  Eczema,  you  have  seen  here  and  observed  how  it 
was  disposed  to  spread,  whereas  this,  you  see,  confines  itself  to 
patches.  You  usually  find  Impetigo  in  children  from  six  to  ten 
years  of  age.  The  secretion  is  not  unlike  honey.  One  of  the  di¬ 
visions  of  Impetigo,  derived  from  its  appearance,  is  that  called  figu- 
rata  and  this  is  a  case  of  that  division  now  before  you.  Impetigo,  as  I 
stated,  occurs  in  patches  and  has  a  run  of  from  12  to  14  days.  The 
disease  may  be  kept  up  for  a  longer  time,  if  nothing  be  done  for  it 
and  the  sources  of  irritation  are  not  removed,  but  about  14  days  is  its 
usual  run.  It  is  in  itself  a  trivia!  disease  ;  but  from  its  frequently 
occurring  on  the  scalp,  you  will  find  parents  often  alarmed  lest  it 
should  be  “the  scald  head.”  Now  Impetigo  is  not  the  disease 
known  under  that  name  ;  neither  have  we  the  consequences  to  fear 
which  we  have  in  that  disease  for  in  scald  head  which  is  Porrigo, 
the  bulbs  of  the  hair  not  unfrequently  become  affected,  so  that  the 
hairs  fall  out  and  permanent  baldness  is  induced — but  if  you  make 
a  true  diagnosis,  if  your  case  is  one  of  Impetigo,  you  need  have 
no  apprehension  on  this  point ;  for  if  the  hairs  do  fall  out,  the  bulbs 


Local  News. 


169 


are  not  affected  and  consequently  the  hair  will  again  appear.  The 
treatment  in  this  case  would  consist  in  keeping  the  hair  close  shaved 
about  the  parts  affected,  and  clean  with  warm  water  and  regulating 
the  digestive  organs. 

Prof.  Parker.  Case  6. — This,  gentlemen,  is  a  case  of  paralysis 
of  the  left  lower  limb  occurring  in  a  little  girl  of  three  years  old. — 
you  see  the  limb  is  smaller  than  the  right,  of  a  lower  temperature, 
and  she  drags  it  when  she  walks.  Now,  here  you  can  detect  no 
spinal  curvature  and  no  disease  of  the  spine.  It  is  very  seldom  you 
will  find  any  thing  written  on  this  kind  of  disease.  You'll  find  it, 
however,  mentioned  by  Underwood  in  his  treatise  on  diseases  of 
children.  And  by  the  way,  among  all  the  treatises  and  compilations 
on  these  diseases,  this  one  of  Underwood’s  is,  I  think  the  best. 


To  the  Editor  of  the  Medical  Gazette  : 

In  the  last  number  of  the  Philadelphia  Journal  of  Pharmacy,  the  new 
mass  of  copaiva  is  described  as  of  latent  discovery,  and  as  being  recom¬ 
mended  by  a  Physician  at  Paris,  and  it  is  therein  proposed  to  be  incorpo¬ 
rated  in  the  forthcoming  U.  S.  Pharmacopoeia  ;  having  however,  prepared 
the  same  according  to  the  Codex  Medicamentaries  Hamburgensis,  of  1835, 
6  years  ago,  and  recommended  the  same  to  my  medical  friends  long  be¬ 
fore  the  gelatine  capsules  came  into  use,  I  beg  leave  to  lay  before  you  the 
recipe  extracted  from  the  above  work. 


R. 

Cera  Alb. 

3ii- 

Balsam  Copaiv. 

?x- 

Pulv.  Cubeb. 

31- 

Nif.  pilal. 

gr.  ii. 

I  am  very  Respectfully,  Yours, 

Dr.  LOUIS  FEUCHTWANGER. 

N.  B.  The  mass  need  not  to  be  kept  ready,  as  it  is  very  easy  to  pre¬ 
pare  it  when  ordered. 


NEW 

YORK 

MEDICAL 

GAZETTE. 

NEW 

YORK,  MARCH  23, 

1842. 

Local  News.  —  We  notice  among  a  series  of  scraps  in  the  last  number 
of  our  Boston  cotemporary  the  following: 

“  Multitudes  of  items  have  crowded  in  upon  us  relating  to  the  two  Med¬ 
ical  Schools  of  New  York,  the  surgical  Cliniques,  their  rivalry,  their  hos¬ 
pitals,  and  lastly  their  quarrels,  about  which  we  don’t  care  a  straw.” — We 
have  reason  to  believe  that  many  such  “  items''  as  our  good  natured  friend 


170 


Editorial  Notice . 


speaks  of  are  afloat,  not  only  in  Boston  but  elsewhere.  It  is  therefore 
worth  while  that  a  word  or  two,  or  “  an  item  ”  or  two,  should  occasionally 
emanate  from  the  scene  of  action  that  the  facts  may  be  known  where  they 
are  of  any  interest.  Now  the  first  and  most  important  fact  is,  that  between 
the  two  schools  there  is  not,  and  never  has  been,  any  quarreling ,  of  this 
our  friends  far  and  near  may  be  well  assured. 

As  to  the  Cliniques  the  facts  are  that  a  Clinique  was  established  by  the 
Professors  of  Anatomy  and  Surgery  at  the  University,  before  the  Lecture 
term  began,  that  it  was  continued  till  about  New-Year,  and  then  for  rea¬ 
sons  that  have  never  been  made  public,  abandoned.  As  to  the  Clinique 
at  the  other  school,  it  had  its  origin  not  in  any  “rivalry”  but  in  the  fact 
that  the  Professors  of  Surgery  and  of  Obstetrics,  having  been  last  season 
connected  with  one  of  the  Dispensaries,  and  having  through  the  session 
given  clinical  instruction  there,  found  it  more  convenient  to  themselves 
and  their  pupils,  to  have  the  patients  come  to  the  college  and  be  there 
prescribed  for ;  this  plan  was  adopted,  the  co-operation  of  the  gentlemen 
connected  with  the  other  Dispensaries  was  afterwards  secured,  and  now 
all  the  most  interesting  cases,  from  the  three  Dispensaries,  are  by  the  lib¬ 
erality  and  zeal  of  the  medical  officers  of  those  Institutions,  made  availa¬ 
ble  for  Clinical  instruction  at  the  College  of  Physicians  and  Surgeons. — 
An  ample  supply  of  interesting  and  instructive  cases  is  thus  secured;  of 
the  manner  in  which  they  are  improved  our  readers  have  an  opportunity 
of  judging,  from  the  reports  of  the  Clinical  Lectures  which  have  appeared 
in  our  columns.  This  Clinique  will  be  continued  during  the  Spring  and 
Summer,  it  will  form  an  important  and  valuable  part  of  the  instruction 
communicated  to  the  students  who  attend  the  Spring  Course.  These  our 
Boston  cotemporary,  and  our  other  friends  at  a  distance,  may  be  assured 
are  all  the  facts  in  which  stories  of  rivalship  and  quarrels  between  the 
schools  have  had  their  origin.  There  has  been,  we  repeat  it,  no  quarrel¬ 
ing,  and  the  two  Cliniques  so  far  from  having  any  thing  of  rivalship  about 
them,  were  conducted  upon  totally  different  principles.  The  one  at  the 
new  school  was  publicly  advertised  and  patients  in  need  of  relief  invited 
to  come  and  receive  gratuitous  aid.  The  Clinique  at  the  old  school  had 
as  we  have  explained,  its  origin  in  the  connexion  of  Professors  Parker 
and  Gilman  with  the  Dispensary,  and  the  essential  feature  of  it  was,  and 
is,  that  patients  were  not  invited  to  come,  but  that  physicians  were  invited 
to  bring  them — the  patient  therefore  always  comes  by  request  and  direction 
of  his  physician ,  in  this  way  the  evil  that  was  complained  of  in  the  Clinique 
of  the  new  school,  viz.,  that  it  interfered  with  the  practice  and  injured 
the  business  of  the  profession,  especially  of  the  Junior  portion  of  it,  is 
avoided,  no  patient  will  find  his  way  to  the  Crosby  Street  Clinique  unless 
his  physician  send  him. 


We  received  some  weeks  since  a  small  pamphlet  entitled  “  Quarterly 
Summary  of  the  Transactions  of  the  College  of  Physicians  of  Phila¬ 
delphia. 

This  Society  was  instituted  in  1786,  and  is  believed  to  be  the  oldest 
College  of  Physicians  in  the  United  States.  They  have  never  as  we  be¬ 
lieve  published  any  thing,  but  at  the  stated  meeting  in  June,  1841,  they 


Medical  Law. 


171 


resolved  “  to  publish  a  bulletin  of  their  transactions” — of  that  resolution 
the  pamphlet  before  us  is  the  fruit.  The  first  thing  that  attracted  our  at¬ 
tention  was  a  list  of  the  officers,  past  and  present  of  the  College — in  it  we 
find  many  of  the  great  names  of  Philadelphia  —  Redman,  Shippen,  Rush, 
Weston,  James,  Parrish,  &c.  We  have  next  a  paper  by  Dr.  Parrish,  the 
worthy  son  of  that  most  skillful  physician  and  excellent  man,  Joseph  Par¬ 
rish — it  is  entitled  Annual  Report  on  Surgery,  and  presents  a  good  view 
of  the  progress  of  that  branch  of  Science.  He  condemns  as  every  sensi¬ 
ble  and  honest  man  has,  or  soon  will,  the  rage  for  tendon  cutting  and  the 
operation  for  stammering,  of  Dieffenbach.  The  rest  of  the  pamphlet  is 
occupied  by  a  summary  of  papers  read  before  the  college,  and  remarks 
upon  them  made  by  the  members;  both  are  creditable  to  the  association. 
We  hope  the  college  will  continue  to  publish  these  transactions. 


We  re-publish  the  subjoined  statement  of  the  Law,  in  relation  to  Grad¬ 
uates  and  Licentiates  from  other  States  practicing  in  New  York,  from  the 
Circular  of  the  Albany  Medical  College.  The  action  of  the  State  Medi¬ 
cal  Society  in  the  premises  is  important,  as  if  the  directions  which  are 
there  given  to  the  County  Medical  Societies,  are  rigidly  followed,  and  we 
believe  that  a  compliance  with  them  is  unavoidable,  Graduates  from  schools 
out  of  this  State  will  hereafter  find  it  very  difficult,  if  not  impossible,  to 
obtain  the  right  to  practice  in  the  State  of  New  York.  For  our  readers 
will  remark  that  the  County  Societies  are  directed  not  only  to  examine 
every  candidate,  but  to  require  the  same  credentials  as  to  time ,  and  terms  of 
study  as  are  required  by  the  laws  of  this  State  before  proceeding  to  an  ex¬ 
amination. 

Our  Albany  friends  have  displayed  not  a  little  of  the  wisdom  of  the 
serpent,  in  obtaining  this  law  and  clinching  it  by  the  action  of  the  State 
Society.  That  it  should  be  published  as  part  and  parcel  of  their  circular, 
is  natural  enough. 

Quere— Will  it  make  part  of  any  of  the  circulars  from  down  East  ?  We 
shall  see— Brother  Jonathan  must  rouse  himself  and  trump  over  this  new 
card,  or  the  New  York  Student  will  not  cross  the  State  line  in  search  of 
good  and  cheap  medical  education. — By  the  way  ;  had  our  friends  in  Ge¬ 
neva  any  thing  to  do  in  this  matter  ?  Those  who  know  the  Prof,  of  Prac¬ 
tice  there,  will  think  they  see  “ the  hand  of  Saul." 


Law  relative  to  Licences  from  other  States. 

A  very  general  opinion  prevails  among  students  in  this  and  one  or  two 
of  the  adjoining  states,  that  the  law  of  this  state  requiring  that  persons  re¬ 
ceiving  Diplomas  in  other  states  or  countries,  should  undergo  an  examina¬ 
tion  before  they  could  legally  practice  physic  and  surgery  in  this  state,  has 
been  repealed.  This  is  an  error.  The  law  has  been  modified  but  not  re¬ 
pealed.  For  the  information  of  all  parties  interested,  the  law  of  the 
state,  as  it  now  stands  in  relation  to  such  persons,  is  here  inserted,  together 
with  the  proceedings  of  the  State  Medical  Society  at  its  last  session,  rela¬ 
tive  thereto. 


17*2 


Medical  Law. 


An  Act  in  relation  to  Foreign  Practitioners  of  Medicine ,  passed  March 

29,  1841. 

The  People  of  the  State  of  New  York,  represented  in  Senate  and  As¬ 
sembly,  do  enact  as  follows  : 

Sec.  1.  The  second  section  of  the  act  entitled  “  An  act  to  amend  title 
seven,  chapter  fourteen,  part  first  of  the  Revised  Statutes  and  for  other 
purposes,”  passed  May  26,  1836,  is  hereby  amended  so  that  it  shall  read 
as  follows : 

No  person  coming  from  another  country  shall  practice  physic  or  surgery 
in  this  state,  until  he  shall  have  been  examined  and  licensed  by  the  cen¬ 
sors  of  the  state  medical  society,  and  no  person  coming  from  another  state 
shall  practice  physic  or  surgery  in  this  state  until  he  shall  file  a  copy  of  his 
diploma  in  the  office  of  the  clerk  of  the  county  where  he  resides,  and  un¬ 
til  he  shall  have  exhibited  to  the  medical  society  of  that  county,  satisfac¬ 
tory  testimonials  of  his  qualifications,  or  shall  have  been  examined  and  ap¬ 
proved  by  its  censors. 

PREAMBLE  AND  RESOLUTIONS 

Of  the  State  Medical  Society ,  relative  to  Foreign  Practitioners ,  passed 

February  2,  1842. 

Whereas  the  Legislature  of  the  State  of  New  York,  by  an  act  passed 
March  20th,  1841,  did  enact  as  follows: 

“  And  no  person  coming  from  another  state  shall  practice  physic  or  sur¬ 
gery  in  this  state,  until  he  shall  have  filed  a  copy  of  his  diploma  in  the 
office  of  the  clerk  of  the  county  where  he  resides,  and  until  he  shall  have 
exhibited  to  the  medical  society  of  that  county,  satisfactory  testimonials 
of  his  qualifications,  or  shall  have  been  examined  and  approved  by  its 
censors.” 

And  whereas,  in  some  of  the  states,  the  requirements  for  license  are  less 
than  in  this  state,  and  the  facilities  for  procuring  Diplomas  greater,  induce¬ 
ments  are  held  out  to  students  to  desert  our  own  schools  for  those  of  other 
states  : 

And  whereas,  while  Diplomas  so  procured  are  received  as  licences  to 
practice  physic  and  surgery  in  this  state,  it  will  be  impossible  to  elevate 
the  character  of  the  profession,  or  to  ensure  any  uniformity  in  the  education 
or  qualification  of  its  members  :  Therefore 

Resolved ,  That  the  several  county  societies  be,  and  they  are  hereby  di¬ 
rected,  to  instruct  their  respective  censors  to  require  the  examination  of 
all  persons  bringing  Diplomas  from  other  states,  as  affording  the  only  sat¬ 
isfactory  evidence  of  their  possessing  the  requisite  qualifications  ;  and  that 
the  same  credentials,  as  to  time  and  terms  of  study,  shall  be  required  be¬ 
fore  proceeding  to  such  examination,  as  are  required  by  the  laws  of  this 
state  in  licensing  physicians  and  surgeons. 

Resolved ,  That  the  secretary  of  this  society  send  a  copy  of  the  foregoing 
preamble  and  resolution  to  the  presidents  of  the  several  county  medical 
societies  of  this  state,  with  a  request  to  lay  the  same  before  their  respective 
societies,  at  their  first  regular  meeting. 

A  true  copy  from  the  minutes  of  the  State  Medical  Society. 

P.  VAN  OLINDA,  Secretary. 


Poisoning  by  Lead. 


173 


ANALYTICAL  DEPARTMENT, 


Poisoning  by  Lead. — The  last  No.  of  the  Western  and  Southern  Medi¬ 
cal  Recorder  contains  a  valuable  practical  article  on  the  above  subject, 
from  Professor  Mitchell  of  Transylvania  University,  occupying  14  pages 
of  that  Journal,  we  can  only  give  our  readers  the  principal  results. 

Dr.  M.  commences  by  observing,  that  much  of  the  dyspepsia  and  bowel 
complaints  prevalent  through  the  country,  is  attributable  to  the  slow  oper¬ 
ation  of  lead,  connected  with  the  various  processes  of  cookery,  using  lead 
pipes  for  water,  &c.  It  is  well  known  he  observes,  that  printers,  plumb¬ 
ers,  &c.,  are  often  attacked  with  colic  merely  from  handling  the  simple 
metal. 

The  first  important  principle  laid  down  and  which  the  writer  assures 
us  is  well  established  by  experiment  in  this  country  and  Europe,  is,  that 
water,  free  of  the  salts  usually  found  in  spring  water,  is  soon  contaminated 
by  coming  in  contact  with  lead,  while  the  presence  of  such  salts  destroys 
the  capacity  of  the  water  to  corrode  the  lead.  Distilled  water  charged 
with  sulphate  of  lead  failed  to  display  any  action  on  the  lead  pipes.  This 
fact  accounts  for  the  impunity  with  which  lead  pipes  are  used  for  convey¬ 
ing  water.  Most  water  used  for  domestic  purposes  being  from  springs 
charged  with  saline  principles.  Lead  we  are  also  informed<  has  been  de¬ 
tected  in  rain  water  falling  from  roofs  covered  with  lead. 

Among  numerous  other  cases  Dr.  M.  gives  one  of  Lord  Ashburnhams 
family  in  England,  who  suffered  with  frequent  colic.  On  analyzing  the 
water  used  for  domestic  purposes,  which  was  conveyed  in  lead  pipes  a 
considerable  distance,  it  was  found  to  contain  an  unusual  amount  of  car¬ 
bonic  acid  —  after  substituting  wooden  pipes,  the  family  suffered  no  more 
from  colic  or  bowel  complaints. 

The  presence  of  lead  may  be  detected  in  water  by  means  of  sulphurated 
hydrogen  gas,  which  strikes  a  brownish  color  and  a  precipitate  finally 
settles  at  the  bottom.  But  as  Dr.  M.  justly  observes,  an  able  analyst  is 
not  always  at  hand,  hence,  the  safest  course  is  to  avoid  the  hazard  by  ma¬ 
king  use  of  agents  not  capable  of  doing  harm. 

Acids  of  all  kinds  particularly  cider  are  extremely  liable  to  become 
poisoned  by  lead.  A  gentleman  boiled  cider  in  a  brew  vessel  wiih  a 
lead  rim.  All  who  drank  of  it  were  sick  —  one  died  immediately — and  the 
master  died  miserably  after  lingering  three  years.  Milk  and  cream  may 
be  poisoned  by  being  kept  in  lead  pans,  and  hence  probably  the  old  reme¬ 
dy  for  diarrhoea,  of  milk,  in  which  shot  had  been  boiled — (forming  acetate 
of  lead,)  a  remedy  now  used  in  the  same  disease. 

Numerous  examples  are  given  where  sugar  has  been  poisoned  by  the 
oxide  of  Lead. 

In  one  instance  a  whole  family  were  violently  attacked  which  finally 
proved  to  have  been  caused  by  using  sugar  from  a  barrel  in  which  white 
lead  had  been  left.  Others  who  used  of  the  same  lot  taken  from  the  cen¬ 
tre  of  the  Barrel  were  not  affected. 

The  oxides  of  lead  when  used  in  plasters,  or  as  glazing  for  domestic 


174 


Poisoning  by  Lead. 

utensils,  often  produce  the  most  deleterious  consequences,  and  the  greatest 
caution  should  be  observed  in  their  use. 

A  fact  of  great  practical  consequence  is  mentioned  by  Dr.  M.,  which 
we  think  is  not  generally  known,  viz.  :  that  the  poison  of  lead  when  ap¬ 
plied  in  a  dilute  state,  often  produces  its  effects  so  slowly  that  they  are 
not  observed  in  months,  or  even  years,  and  until  too  late  for  precautionary 
measures. 

The  evil  effects  of  lead  when  used  for  sweetening  wines,  refining  syr¬ 
ups,  is  well  known  —  a  gentleman  had  suffered  from  colic  two  days  in 
succession  after  drinking  part  of  the  same  bottle  of  wine  each  day — by  ac¬ 
cident  the  bottle  was  broken  and  found  to  contain  a  quantity  of  shot 
wedged  in  the  sharp  angle  of  the  bottom. 

Habit  often  enables  patients  to  escape  with  impunity,  while  palsies  have 
been  induced  by  sleeping  a  single  night  in  a  newly  painted  room 

Treatment .  —  Dr.  M.,  besides  stomach  pump,  vomiting,  and  other  usual 
remedies,  places  great  reliance  on  sulph.  magnesia,  compound  infus.  of 
roses,  with  a  view  to  form  an  insolublue  sulphate  of  lead  in  the  stomach. 
Castor  and  olive  oils  are  to  be  used  freely. 

We  have  known  some  lead  manufacturers  who  required  their  workmen 
to  take  weekly,  a  dose  of  from  four  to  eight  ounces  of  these  oils  as  a  pre¬ 
ventive,  and  it  was  said  with  the  best  effects. 


We  extract  the  following  very  judicious  and  truly  philosophical  obser¬ 
vations  from  a  paper  by  M.  E.  Bowyer,  in  a  late  number  of  the  Parisian 
Medical  Gazette,  to  which  we  are  so  frequently  indebted  for  valuable 
matter. 

Intermittence  whenever  it  manifests  itself  in  a  disease,  constitutes  the 
essential  phenomenon  of  that  disease,  and  this,  whatever  may  be  the  se¬ 
ries  of  symptoms  which  appear  during  the  paroxysm.  The  therapeutics 
of  all  intermittent  affections  is  based  upon  this  fundamental  fact.  The 
symptoms  which  appear  during  the  paroxysm  are  only  of  secondary  im¬ 
portance  whatever  may  be  their  severity  ;  and  medication  directed  against 
them  is  entirely  unimportant  unless  we  have  also  a  special  treatment  for  the 
periodicity  of  these  symptoms.  There  is  scarcely  a  disease  in  the  whole 
circle  of  internal  pathology,  which  has  not  presented  itself  in  the  inter¬ 
mittent  type,  indeed  many  external  affections  have  been  noticed  in  this 
form. 

It  is  in  vain  to  oppose  to  an  intermittent  disease  the  most  rational  treat¬ 
ment,  in  vain  we  employ  against  it  the  medication  which  ordinarily  tri¬ 
umphs  over  it  when  in  the  continued  form,  we  shall  not  thus  cure  a  single 
patient  unless  we  attack  the  fundamental  phenomenon  —  the  intermittence 
which  alone  is  of  more  importance  than  all  the  other  phenomena  which 
constitute  the  disease  during  its  paroxysm.  M.  Braid,  speaking  of  the 
neuralgia  of  the  face  which  so  frequently  appears  in  the  paroxismal  type, 
says,  “  the  consideration  of  the  type  of  the  disease  predominates  over  all 
others,  for  it  is  nearly  useless  to  seek  for  the  cause  of  tic  douloureux  when 
the  attacks  of  the  disease  are  distinctly  periodic.” 

This  may  be  applied  to  all  periodic  diseases,  and  in  my  opinion  it  leads 
us  to  the  only  rational  treatment  which  can  be  successfully  employed 
against  them. 


Gleanings. 


175 


G  LEANINGS, 


Louisville  Medical  Institute . — The  fifth  annual  commencement  of  this 
school  was  celebrated  on  the  3d  instant.  The  degree  of  M.  D.  was  con¬ 
ferred  on  fifty-three  young  gentlemen  alumni  of  the  school,  two  graduates 
of  from  other  colleges  were  admitted  ad  eundem,  and  the  honorary  degree 
M.  D.,  was  conferred  on  four  practitioners,  from  Kentucky,  Tennessee  and 
Alabama.  The  valedictory  address  was  delivered  by  Professor  Caldwell. 

The  number  of  bona  fide  students  was  263,  of  whom  Kentucky  furnished 
85—  Tennessee  81 — Alabama  and  Mississippi,  each  30  — the  remainder 
were  from  States  South  and  West.  According  to  the  Louisville  Journal 
this  is  the  second  school  in  the  United  States,  standing  next  to  Philadelphia, 
which  the  editor  thinks  it  may  soon  equal,  yet  says  they  are  willing  to 
rank  second  to  the  oldest  school  in  the  country.  If  quackery  is  invading 
the  country,  our  medical  schools  bid  fair  to  send  forth  an  army  fully  com¬ 
petent  at  least  in  numbers,  to  cope  with  it. - Dr.  C.  Knapp  has  been 

removed  from  the  superintendence  of  the  Insane  Hospital,  of  Maine,  and 
Dr.  Isaac  Ray  has  been  appointed  his  successor  the  whole  number  of  pa¬ 
tients  during  1841 ,  was  133  ;  deaths  six. 


Obituary.  —  Died  in  South  Berwick,  Maine,  Albert  Bartlett,  M.  D., 
aged  27. 


INSTITUTION  FOR  THE  TREATMENT  OF  CALCULOUS  AFFECTIONS, 

AND  OTHER  DISEASES  OF  THE  URINARY  ORGANS. 

The  undersigned,  formerly  Professor  of  Surgery  in  the  College  of  Physicians  and  Surgeons  of  the 
University  of  the  State  of  New  York,  and  in  the  Medical  College  of  Ohio,  begs  leave  to  inform  the 
Medical  Profession  that  he  has  established  an  Institution  for  the  accommodation  of  patients  laboring 
under  Calculous  Affections,  Fistulse,  Diseases  of  the  Bladder,  Kidneys,  &c. 

As  the  Members  of  the  Profession  are  generally  aware  that  the  undersigned  has  practised  Lithotrity 
for  many  years,  and  devoted  much  of  his  time  to  diseases  of  the  urinary  organs,  he  hopes  that  this 
Institution  will  meet  with  the  approbation  of  his  friends  in  the  profession  and  the  public. 

Any  person  desiring  further  information,  may  apply,  personally  or  by  letter,  to  him,  at  No.  9  Park 
Place ,  New  York. 

October,  \2th,  1841 .  ALBAN  GOLDSMITH,  M.  D. 


DR.  ALBAN  GOLDSMITH  will  deliver  a  course  of  lectures  on  diseases  of  the  genito-urinary 
organs,  including  Lithotritus,  &c.,  every  Saturday  at  2  p.  m.,  at  the  Eastern  Dispensary.  At  the 
same  time  operations  will  be  performed  with  clinical  remarks.  Students  and  Physicians  are  invited 
to  attend. 


DR.  CHAPIN’S  UTERO-ABDOMINAL  SUPPORTERS. 

Trusses,  Suspensory  Bandages,  fyc. 

The  subscriber  having  appointed  Dr.  Uriah  Turner,  General  Agent  for  the  above,  a  constant  sup¬ 
ply  will  be  kept  at  the  Office  of  the  Medical  Gazette,  No.  121  Fulton  htreet—  Liberal  discount 
to  wholesale  purchasers. 

Many  eminent  physicians  in  the  city  give  these  Instruments  the  preference,  and  those  practitioners 
unacquainted  with  them,  can  scarce  be  aware  of  the  relief  they  afford  in  one  of  the  most  distress¬ 
ing  class  of  diseases  with  which  the  female  sex  are  afflicted.  J.  R.  Chapin. 

New  York ,  Oct.  22,  1841. 

Dr.  Turner  is  also  Agent  for  Dr.  Haynes’ 

UTERO-ABDOMINAL  SUPPORTERS. 

An  entirely  new  article,  highly  spoken  of  in  the  Boston  and  Philadelphia  Medical  Jouinals,  and  ex¬ 
tensively  used  in  the  former  city.  Physicians  are  respectfully  invited  to  call  and  examine  them; 


176 


Medical  Advertisements 


SPRING  COURSE  OF  LECTURES  AT  THE  COLLEGE  OF  PHYSICIANS 

AND  SURGEONS, 

No.  67  Crosby  Street,  New  York . 

The  Association  by  whom  the  spring  course  of  Lectures  was  last  year  delivered,  have  the  plea¬ 
sure  to  inform  the  Medical  Profession  and  Students  of  Medicine,  that  the  course  will  be  re-com¬ 
menced  next  spring,  with  an  additional  number  of  lecturers,  and  as  they  hope,  with  added  facilities 
for  Medical  Instruction.  The  course  will  commence  on  Monday,  the  21st  of  March,  1842,  and  con¬ 
tinue  till  the  1st  of  June.  Three  Lectures  will  be  delivered  daily,  except  Saturday — hours  from 
nine  to  twelve,  A.  M. 

The  following  Lectures  will  constitute  the  course  : 

On  the  Diseases  of  the  Eye,  by  Geo.  Wilkes,  M.  D.,  Surgeon  to  the  New  York  Eye  Infirmary 
Clinical  instruction  at  the  Infirmary. 

On  Surgical  Anatomy,  by  G.  Buck,  M.  D.,  Surgeon  to  the  New  York  Hospital. 

On  the  Diseases  of  the  Skin,  by  H.  D.  Bulkley,  M.  D. — Clinical  Instruction  at  the  New  York 
Dispensary. 

On  the  Pathology  of  the  Female  Organs  of  Generation,  by  C.  R.  Gilman,  M.  D-,  Professor  of  Ob¬ 
stetrics  and  the  Diseases  of  Women  and  Children  in  the  College  of  Physicians  and  Surgeons. 

On  Materia  Medica,  (new  articles),  by  B.  McCready,  M.  D. 

On  the  Diseases  of  the  Mind,  by  J.  Macdonald.  M.  D.,  late  Superintendant  of  the  Bloomingdale 
Asylum,  now  of  the  Retreat  at  Murray  Hill. 

On  Operative  Surgery,  by  W.  Parker,  M.  D.,  Professor  of  Surgery  in  the  College  of  Physicians 
and  Surgeons. 

On  the  Anatomy  of  the  Nervous  System,  by  J.  Quackenboss,  M.  D.,  Demonstrator  of  Anatomy, 
in  the  College  of  Physicians  and  Surgeons. 

On  the  Diseases  of  the  Abdominal  Viscera,  by  W.  C.  Roberts,  M.  D. 

On  the  Diseases  of  the  Chest,  Percussion  and  Auscultation,  by  J.  A.  Swett,  M.  D.  Clinical  In¬ 
struction  at  the  New  York  Dispensary. 

On  Clinical  Surgery  and  Surgical  Pathology,  by  J.  Watson,  M.  D.,  Surgeon  to  the  New  York  Hos¬ 
pital.  This  course  will  be  delivered  at  the  Hospital. 

On  Fractures  and  Dislocations,  by  R.  Watts,  Jr.,  M.  D.,  Professor  of  Anatomy  in  the  College  of 
Physicians  and  Surgeons. 

As  this  course  was  originally  undertaken  and  is  now  prosecuted  with  the  single  aim  of  doing 
something  for  the  cause  of  sound  and  thorough  Medical  Education,  and  particularly  to  develope  the 
great  advantages  which  New  York,  by  her  superior  size,  and  by  the  consequent  abundance  and  va¬ 
riety  of  Diseases  which  are  met  with  in  her  Hospitals,  Alms-house  and  Dispensaries,  offers  to  the 
Student  of  Practical  Medicine  and  Surgery,  the  Association  have  determined  to  continue  the  fee 
for  the  Coarse  at  a  price  merely  nominal — intending  thereby  to  place  the  instruction  offered,  within 
the  reach  of  all  who  are  anxious  for  Professional  improvement. 

Fee  for  all  the  Lectures,  $10. 

New  York,  October,  28th,  1841. 


Observations  on  Strabismus,  with  engravings,  &c.,  by  Alfred  C.  Post,  M.  D.,  one  of  the  Surgeons 
of  the  N.  Y,  Hospital,  formerly  one  of  the  Surgeons  of  the  N.  Y.  Eye  Infirmary,  &c.  &c.  Published 
and  sold  by  Charles  S.  Francis,  252,  Broadway. 


WM.  R.  GOULDING,  35  1-2  CPIATHAM  STREET.— SURGICAL  INSTRUMENT  MAKER  IN 
GENERAL. — Has  on  hand,  and  makes  to  order,  all  kinds  of  Surgical  Instruments,  of  the  most  im¬ 
proved  patterns,  and  of  the  best  workmanship.  From  a  long  experience  in  manufacturing,  he  feels 
confident  in  recommending  his  instruments  to  the  faculty  in  general,  to  whom  he  returns  his  thanks 
for  past  favors,  and  solicits  a  continuation  of  their  patronage. 

He  begs  leave  to  call  the  attention  of  the  profession  to  an  instrument  recently  invented  for  intro¬ 
ducing  suppositories  into  the  rectum,  &c.  in  cases  of  irritation  or  inflammation  of  that  tube,  or  of  the 
neighboring  parts. 

New  York ,  September  1,  1841.  ly. 


GEO.  TIEMAN,  63  CHATHAM  ST.— SURGICAL  INSTRUMENT  MAKER.— Has  on  hand  all 
kinds  of  Surgeons’  Instruments,  warranted  of  the  best  workmanship.  Every  variety  of  Instruments 
made  to  order  at  short  notice.  From  a  long  experience  in  Europe  and  America,  G.  T.  feels  confi¬ 
dent  in  recommending  his  Instruments  to  his  old  customers,  and  Surgeons  generally,  and  solicits  a 
continuance  of  their  patronage. 

New  York,  July  21,  1841. 


THE  NEW  YORK  MEDICAL  GAZETTE  is  published  every  Wednesday,  by  Uriah  Turner,  M. 
D.,  No.  121  Fulton  St.,  entrance  through  Dean  &  Trevett’s  Bookstore,  to  whom  all  communications 
should  be  addressed,  post.  paid.  Price  $3  per  annum,  payable  in  advance — after  three  months  $4. 
No  subscriptions  received  for  less  than  one  year. 

By  the  regulations  of  the  Post  Office  Department,  Post-Masters  are  allowed  to  forward,  under  their 
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If  this  is  done,  the  favor  will  rarely  be  denied  by  any  Post-Master.  Advertisements  inserted  on  fa¬ 
vorable  terms. 


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